Fecal Incontinence: Prevalence, Severity, and Quality of Life Data from an Outpatient Gastroenterology Practice

Abstract

Background. The prevalence of fecal incontinence varies tremendously as a result of inadequate data collection methods. Few office-based studies have assessed the prevalence of fecal incontinence and none have looked at modifiable risk factors or effect on quality of life. Design, Settings, Patients, and Main Outcome Measures. Five hundred patients who visited our inner city, university-based gastroenterology practice, were asked about symptoms of fecal incontinence. We also retrospectively reviewed 500 charts to identify the frequency of patient-physician reporting of fecal incontinence. Results. Of the 500 patients that were directly questioned, 58 (12%, 43 women, 15 men) admitted to fecal incontinence compared to 12 (2.4%) in the retrospective arm. Patients with fecal incontinence and loose/watery stool reported the lowest quality of life scores. While the average severity score was similar between men and women, women had a significantly lower average quality of life score (3.04 versus 2.51; P < 0.03). Conclusions. The identification of fecal incontinence increases when patients are directly questioned. Identifying and treating patients with loose stool is a potential strategy to improve quality of life in this patient population. In men and women with similar severity of fecal incontinence, women have a significantly lower quality of life.

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

“…In fact, more than 4 additional Wexner scale points were necessary to overcome the effect of being female. Our results are consistent with those of Alsheik et al, 7 although in that study all four FIQL subscales were combined, and partially with Cohan's, 32 who found male gender to be significantly associated with improved coping and embarrassment scores. However, other studies did not find significant differences between the sexes 30 or reported an improved life style scoring associated with being female.…”

“…Although QoL for patients with fecal incontinence has been researched, little has been said about the impact of gender. Few studies of community-dwelling patients have tried to explore this aspect and results have varied: one study did not find differences between genders, 30 another found slightly better QoL in women, 31 in a third, higher coping and embarrassment scores were associated with men, 32 and a fourth study 7 reported that women had a significantly lower average QoL; in this latter study, however, the FIQL dimensions most affected were not specified. Knowledge of how gender affects QoL can be of great importance when treating and counseling patients.…”

“…6,7 It is thought that prevalence may be underestimated because patients are often reluctant to report their symptoms. 8 Australian, 8 New Zealand, 9 Spanish, 10 and Korean 11 studies have reported prevalence rates of 15%, 12.4%, 10.8%, and 6.4% respectively, for random samples drawn from the general population.…”

Functional Evaluation of Obese Patients with Symptoms of Fecal Incontinence Using Anorectal Electromanometry

“…Though affecting mostly elderly women, the prevalence of FI in the general population is highly variable, with reports ranging from 0.4% to 18% [2][3][4][5]. The actual prevalence is likely higher than this since many cases remain unreported due to embarrassment.…”

“…FI affects both genders but is more prevalent among women, especially the elderly [1]. The overall prevalence is 0.4-18% [2][3][4][5], but the condition is often unreported due to embarrassment, despite significant loss of quality of life [5,6].…”